Canadian Diabetes Association Recommendations for Human and Animal Insulins, 1997

(Our) survey results indicate that for some people, changing insulins has a negative impact on their health, well-being and quality of life. People need more information as to the reasons for changing their insulin and they need to have the choice. They need the support of their physicians and their diabetes health care teams during this time of change-over. The (Canadian) National Advocacy Committee is committed to advocating for the continuation of beef/pork insulins for those whose health, well-being or quality of life will be affected by the change.

Diabetes Dialogue, Fall 1997, Canadian Diabetes Association

The following is the summary of a position statement that originally appeared in the June 1995 edition of Canadian Diabetes, a publication of the Canadian Diabetes Association’s Clinical & Scientific Section.

After reviewing the evidence, the ad hoc committee came up with a list of recommendations and a protocol for switching insulins, which the Association du Diab_te du Qu_bec and the Canadian Diabetes Asso-ciation’s Clinical & Scientific Section endorsed.

The key recommendations include:

Patients who can control their diabetes well with beef/pork insulin should continue on it.

Sometimes, switching to human insulin means increased injections. If patients are under control with beef/pork insulin and don’t want more injections, that’s another reason for staying with animal insulin.

Patients who believe they can feel low blood sugar better on animal insulin can try returning to it.

The small percentage of patients on animal insulin who have the problems mentioned earlier (allergies, losing fatty tissue at injection sites, resistance to insulin’s effects) should switch to human insulin.

In cases where insulin is needed only intermittently, human insulin is better.

Who can decide on changing the type of insulin? That should be left to the endocrinologist or the treating physician. Except in emergencies, pharmacists are not authorized to exchange human insulins for beef/pork insulins. Unless their reasons are justified, medical professionals also shouldn’t pressure patients to switch from animal to human insulins.

With that in mind, the ad hoc committee suggested that when switching insulins:

All transfers should be medically supervised.

Patients must receive detailed information about how the change will occur.

To effectively adjust the doses of insulin, patients must temporarily do more self blood sugar testing more often. If not, closer medical follow-up is required.

Patients who were previously on animal insulin should lower the initial dose of human insulin by 10 to 20 percent.

Patients can use the same dosage schedule if switching from Novo Nordisk’s animal insulin to Eli Lilly’s animal brand of insulin.

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Greetings from Nadia

A few facts about me in case you are new to my column and site.

My life in the diabetes community started at a young age as the secret keeper of my maternal and paternal Grandmothers. They both had type 2 diabetes and my days spent alone with them exposed me to their misunderstanding of how their diabetes really affected them. Eating candy bars, hiding the candy wrappers and smoking cigarettes seemed innocent enough to them. A decade later I married a type 1 person living with diabetes and experienced the full court of the diabetes spectrum with my type 2 family members and type 1 husband of almost 20 years.

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My grandmothers, the type 2 have struggled with their diabetes as long as I could remember. Later my mother followed in her mother’s footsteps. Sadly, my brother followed in my mother’s footsteps and experienced an early passing at the age of 53. My brother Jamal’s passing had the greatest impact on me. Probably because were the Irish twins; eleven months apart and his departure devastated me.

As I tell most people, diabetes is not a glamorous profession. Most people that work in the industry have a personal connection. This is why I am still here publishing after 26 years.

On the flip side of the coin, helping and inspiring people is my mission. I understand the daily challenges you face regardless of your education, IQ and economic circumstance. I am not a healthcare professional. Simply a lay person who has lived with a Type 1 and Type 2 family member who struggled with their disease. My former Type 1 husband was a role model in how to manage your diabetes, while my intelligent family members were role models on how an invisible disease can be misunderstood, devastating the quality of their life while leaving heart broken family members behind.

The perils of my experience have taught me to never judge anyone. As knowledgeable as I am, I also realize that I have no idea of the strings that pull at each person heart.

What I love about the diabetes community?

Once I meet someone and we share that we have a common experience; their diabetes and my life long experience as a care taker, we tend to have an instant bond. Think about it. How many people do you meet who you feel really get you right after your introduction? The conversations that follow tend to be very personal. Not a common experience with all strangers.

AskNadia Column

I started this column because where ever I go, people tend to ask me a lot of diabetes questions.

My answers are my opinions and it is not to be replaced by your healthcare professional’s opinion. The answers to your question in most cases will include research and other links to give you a borader perspective on your question.